How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $457.09 Median $2,630.27 Typical High $12,022.64 | Facility | None | $457.09 | $2,630.27 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $354.81 Typical High $1,000.00 | Professional | None | $251.19 | $354.81 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,202.26 Typical High $4,570.88 | Facility | None | $524.81 | $1,202.26 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $398.11 | Professional | None | $208.93 | $263.03 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $239.88 Median $309.03 Typical High $323.59 | Facility | None | $239.88 | $309.03 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $426.58 Typical High $2,398.83 | Facility | None | $251.19 | $426.58 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $588.84 | Professional | None | $269.15 | $380.19 | $588.84 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $251.19 Median $416.87 Typical High $2,398.83 | Facility | None | $251.19 | $416.87 | $2,398.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $588.84 | Professional | None | $269.15 | $380.19 | $588.84 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $234.42 Typical High $426.58 | Professional | None | $33.88 | $234.42 | $426.58 |
SummaCare Setting Facility Modifier None Typical Low $134.90 Median $141.25 Typical High $162.18 | Facility | None | $134.90 | $141.25 | $162.18 |
SummaCare Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $446.68 | Professional | None | $245.47 | $323.59 | $446.68 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $6,165.95 | Facility | None | $691.83 | $1,445.44 | $6,165.95 |
United Setting Professional Modifier None Typical Low $194.98 Median $323.59 Typical High $575.44 | Professional | None | $194.98 | $323.59 | $575.44 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $173.78 Typical High $190.55 | Professional | 52 · Reduced service | $125.89 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $70.79 Typical High $77.62 | Professional | 53 · Discontinued | $50.12 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $263.03 Typical High $288.40 | Professional | 54 · Surgery only | $186.21 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $52.48 Typical High $57.54 | Professional | 55 · Aftercare only | $37.15 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $35.48 Typical High $38.90 | Professional | 56 · Pre-op care only | $25.12 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $245.47 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $173.78 | $245.47 | $269.15 |
Where Ohio sits
The same service costs 5.2 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Ohio· 48th of 51
$282
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.